Individual
HEATHER L RICHIE
Active
Sole proprietor
No
Provider details
NPI number
Gender
F
Credential
M.D.
Contact information
Practice address
1101 S 28TH AVE STE A, HATTIESBURG, MS 39402-2610
(601) 261-1640
(601) 579-5240
Mailing address
415 S 28TH AVE, HATTIESBURG, MS 39401-7246
(601) 288-4329
(601) 579-5240
Taxonomy
Speciality
Code
Description
License number
State
207R00000X
Internal Medicine Physician
110760
MO
207R00000X
Internal Medicine Physician
Primary
22801
MS
208M00000X
Hospitalist Physician
22801
MS
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
05279741
—
MS
05
—
204649800
—
MO
Enumeration date
06/09/2005
Last updated
07/21/2020
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